03. Bachelor's Thesis
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Item Embargo A JOURNEY OF UNDERSTANDING: A THEMATIC ANALYSIS ON THE NURSING STUDENTS’ REFLECTIONS ON WORKING WITH CHILDREN WITH AUTISM.(Nazarbayev University School of Medicine, 2025-05-08) Balkibekova, MereyIntroduction: Nursing students who work with children with autism gain valuable hands-on experience that directly impacts their professional and personal development. This study, based on the practical experience of working by Nazarbayev University students at the Social Development Center for Children with Autism “Orda”, offers insights on the current situation of autism in Kazakhstan. Aim: This study aimed to describe the experiences of Bachelor of Science in Nursing students at Nazarbayev University toward working with children with autism. Methods: This study utilized a descriptive qualitative research method using students’ reflection papers as data. Thematic analysis was used to analyze the 20 reflection papers to identify patterns (themes). This research maintained ethical principles, accuracy, rigor, and trustworthiness. The data were coded manually. Results: From the in-depth analysis of the data, 181 initial codes were extracted. The initial codes of similar meanings were combined into 18 sub-themes and finally developed into five significant themes: personal and professional growth, challenges and resilience, relationship building, impact on future career path, and transformational learning. Conclusion: Nursing students' experience working with children with autism demonstrated growth in empathy, communication, and adaptability, as well as an understanding of the current issues and stigmas of autism. Their experiences toward working with children with autism may profoundly benefit the development of autism awareness campaigns and the improvement of care provision and facilities for these children.Item Restricted THE ANALYSIS OF A PATIENT SURVIVAL RATE AFTER KIDNEY TRANSPLANTATION IN KAZAKHSTANT(Nazarbayev University School of Medicine, 2023-04-25) Kuspanov, AbualiKidney transplantation has become a broadly used practice in Kazakhstan. However, it is vital to ensure the high survival rates of patients after this procedure. Therefore, this paper is trying to evaluate the extent to which factors such as age, donor type, HLA mismatch, and maintenance therapy affect survival. To perform this, the discharge reports of 77 patients were analyzed, and a database with the variables was created. Then, the Cox and logistic regression models were used to analyze the effect of variables on patient survival. Overall, ten or 13% of death cases were reported among this group, so the patient survival rate is 87%. However, the unadjusted Cox and logistic regression models showed no significant statistical effect of age, gender, donor type, HLA mismatch, and type of drugs used. Although the literature justifies their odds and hazard ratios, the small sample size might be the reason for their insignificant statistical effect. It is recommended to further analyze the patient survival rate with a much larger sample size and other potential risk factors.Item Embargo ANTENATAL MENTAL HEALTH SCREENING AMONG PREGNANT WOMEN IN ONE AMBULATORY OBSTETRIC UNIT: A BEST PRACTICE IMPLEMENTATION PROJECT(Nazarbayev University School of Medicine, 2025-04-24) Kartalova, Perizat; Tulenova, KarlygashIntroduction: While the pregnancy is associated with the time of excitement, the emotional burden of it is often overlooked in many healthcare settings, affecting the mental health of a pregnant women. Antenatal depression, panic disorders, anxiety and other mental health disorders can have a lasting effect both on the health of mother and a fetus. Aim: The study aimed to promote antenatal mental health screening among pregnant women in one ambulatory obstetric unit in Kazakhstan. Methods: This study is a quality improvement project designed through the JBI Evidence Implementation process model guided by the JBI evidence-based healthcare (EBHC) framework. A baseline assessment of compliance with the best practice guidelines regarding the antenatal mental health screening was conducted. As a result, the identified gaps were addressed with the following strategies, targeted education of the healthcare workers, development of a clear algorithm of a mental health assessment and referral system, and a policy update for the sustainability of the introduced practices. Results: Baseline audit demonstrated low compliance with the best practice recommendations, especially inconsistencies were noticed in the lack of training for medical workers in women-centered communication and follow-up assessments of women who are at risk of antenatal depression. After the implementation of the strategies, a significant improvement was noted with Criterion 1 about training staff on women-centered communication and psychosocial assessment, increasing from 27.27% to 85.71% of compliance, and Criteria 6 and 7 achieving 100% compliance, which are about follow-up assessments in women scoring high on the Edinburgh Postnatal Depression Scale. Other criteria showed persistently high compliance with the best practice. Conclusions: The study promoted antenatal mental health screening among pregnant women in one ambulatory obstetric unit. The study successfully incorporated changes in the department's practices with the use of strategies focused on low compliance criteria, as well as considering interventions’ sustainability.Item Embargo ASSOCIATIONS BETWEEN PERCEIVED CAMPUS MENTAL HEALTH CULTURE AND STUDENTS’ QUALITY OF LIFE: A CROSS-SECTIONAL AND CORRELATIONAL STUDY(Nazarbayev University School of Medicine, 2025-04-24) Akmalova, DiyoraIntroduction: Campus mental health culture may significantly influence students’ quality of life. While existing literature reveals that perceived campus mental health culture (stigma, attitudes, and barriers to treatment) may play a complex role in influencing students’ help-seeking behavior, only a few studies have examined how these factors relate to students’ health-related quality of life. Aim/s: The following study analyzed the relationships between demographic variables, campus mental health culture (stigma, attitudes, and barriers to treatment), and quality of life. Methods: The study took place at the Nazarbayev University campus and involved 372 samples. It utilized a cross-sectional survey design. Students were recruited via email invitations, social media posts, and posters through a convenience sampling method from January to March 2025. Data was gathered online through a self-reported questionnaire, with the following tools being used: the Short Form-12v2 Health Survey (SF-12v2), the Discrimination-Devaluation Scale (DDS), the Attitudes toward Seeking Professional Psychological Help-Short Form (ATSPPHSF), and the External Demands subscale of the Barriers to Treatment Participation Scale (BTPS). Results: The study revealed that personal mental health history and gender were stronger predictors of mental health outcomes, while the barriers to treatment had a noteworthy impact on the physical outcomes of quality of life. Conclusions: Our findings suggest that interventions to improve students' quality of life may benefit from addressing common obstacles to treatment (e.g., scheduling, academic obligations, and fatigue). Also, targeted strategies are needed to reflect socio-demographic differences that relate to quality of life, stigma, help-seeking attitudes, and barriers to promote more equitable access to care.Item Open Access ASSOCIATIONS OF INSULIN RESISTANCE, Β-CELL FUNCTIONING, AND CARDIOVASCULAR RISK FACTORS WITH PREDIABETES IN A WORKING AGE POPULATION FROM TURKISTAN(Nazarbayev University School of Medicine, 2023-04-20) Li, Mariya; Sarria-Santamera, AntonioThe incidence of T2DМ will increase each year since the prevalence of people with prediabetes is even higher. This study is aimed to describe the clinical, biochemical, and metabolic characteristics of people with prediabetes, analyse the effect of insulin resistance (IR) and impaired β-cell function identified by the homeostasis model assessment values on prediabetes, and identify the risk factors for prediabetes, IR and impaired function of β-cell. The data for the study was obtained from workers of the Khoja Akhmet Yassawi International Kazakh-Turkish University (Turkistan, Kazakhstan). The final sample contained 419 participants aged between 27-69, including 237 healthy and 182 prediabetic individuals. Multivariable logistic regression models were computed. This study demonstrated prediabetes population has older age, a high median BMI and systolic blood pressure, high obesity prevalence, and dyslipidemia characteristics. IR and impaired β-cell function are positively correlated with prediabetes. Waist circumference, age, systolic blood pressure, IR, and poor β-cell are risk factors for prediabetes. Prediabetes is positively associated with IR and poor β-cell function. No model was found to describe IR risk factors in the population. Still, it revealed that age and total cholesterol levels could be used to predict poor β-cell function in prediabetic individuals.Item Embargo BELIEFS ON BREAST CANCER AND PREVENTIVE SCREENINGS AMONG WOMEN IN KAZAKHSTAN: AN ONLINE SURVEY(Nazarbayev University School of Medicine, 2025-04-24) Shodimatova, GavkharIntroduction: Breast cancer is a major cause of female mortality and morbidity across the globe. Kazakhstan remains one of the most highly affected countries, despite breast cancer screenings such as mammography and ultrasound being made mandatory and promoted by the government. Aim: The study assessed the beliefs of women of Kazakhstan in breast cancer and preventive screenings and their associated factors. Methods: The study employed a descriptive cross-sectional design using an online survey. The survey's first section comprises demographic variables. The second section uses the Modified Thai Version of Champion’s Health Belief Model Scale (MT-CHBMS), comprising 10 subscales with 64 items. A multiple linear regression analysis was performed to examine the factors associated with the belief in breast cancer and screening. Results: This study identified low screening practices among participants. Last year, most of the participants did not perform breast self-examination (67.4%), had not undergone mammography (69.7%), or ultrasound (67.8%). Analysis of the Modified Thai Version of Champion’s Health Belief Model Scale (MT-CHBMS) showed Health motivation was the highest perceived subscale (M = 3.64). Although participants expressed strong beliefs in the benefits of mammography (M = 3.63) and breast self-examination (BSE) (M = 3.61), a low score for perceived susceptibility of breast cancer (M = 2.15) indicates the low personal sense of risk among respondents. Participants reported low self-efficacy in performing BSE (M = 2.83). The regression analysis implies that the belief model explained 23.4% of the variation in women’s breast cancer and screening beliefs (Adjusted R² = 0.234, p < .001). 8 out of 10 HBM subscales were significant predictors. Participants with a family history of breast cancer and those who had an ultrasound, had a higher perceived risk of breast cancer. Participants with regular gynecological exams reported lower perceived risk. Ethnic and socioeconomic factors influenced beliefs: while unemployed participants encountered more barriers to BSE, Uzbek women reported fewer perceived benefits of mammography and fewer barriers to BSE. Conclusion: This research studied existing beliefs about breast cancer and preventative screenings among women in Kazakhstan. An online survey found that beliefs can differ due to sociodemographic factors such as family income, screening history, and employment status.Item Restricted DEMOGRAPHIC AND CLINICAL PORTRAIT OF WOMEN WITH RECURRENT PREGNANCY LOSS IN KAZAKHSTAN(Nazarbayev University School of Medicine, 2023) Turmagambet, LuizaBackground. Recurrent pregnancy loss (RPL) is a complex health challenge with multiple risk factors. No conclusive study describes demographical and clinical risk factors associated with RPL in Kazakhstan. This study aims to identify demographic and clinical risk factors that influence or contribute to RPL in Kazakhstan. Methods. This cross-sectional study was conducted among women with RPL attending outpatient clinics in Astana, Kazakhstan. The primary study instrument was a 23-item clinical questionnaire. Nonparametric statistical tests and correlation analysis examined differences and associations between variables. Results. Ninety-five study subjects with two or more spontaneous miscarriages participated in this study. The median number of pregnancies (gravidity) and live births (parity) were 3.5 and 0, respectively. The number of pregnancies and deliveries was statistically discernible from the number of spontaneous miscarriages. Spearman's correlation analysis showed positive correlations between gravidity and parity with RPL (r-value = 0.86 and 0.30). Conclusion. There is a direct association between gravidity and parity with RPL. However, no statistical discerning was found concerning identified risk factors such as maternal age and BMI. Further research is needed to verify the magnitude of the current study’s findings and to identify additional risk factors that predispose Kazakhstani women to RPL.Item Restricted DEVELOPING A SYSTEM FOR ANALYZING THE DOWNSTREAM EFFECTS OF CCL5 DERIVATIVES ON THE CCR5 PATHWAY(Nazarbayev University School of Medicine, 2023) Mustafa, KamshatBackground: Various types of diseases are known to be influenced by the ССL5/ССR5 pathway, including cancers and HIV. Inhibiting the attachment of CCL5 to CCR5 has shown promise in preclinical studies as a way to suppress the growth of the tumor and improve outcomes in cancer patients. In this study, we want to observe how p21, p53, and Mdm2 protein expressions that play important roles in cell growth will change with different modifications of CCL5. We aim to check the level of expression of these proteins in the cell line derived from brеаst саnсеr - МСF-7. Маtеrіаls & Меtһоds: МСF-7, МDА-МВ-231, СНО/CCR5, and СНО/WT cell lines were cultured for further RNA isolation, RT-PCR, and qPCR experiments. RNA isolation and RT-PCR were performed in order to check whether the expected genes exist. In order to check the expression levels of three target proteins quantitative PCR was done. Results: RT-PCR interpretation on a gel showed that cell lines express p21, Mdm2, and GAPDH genes, but failed to show p53. Only MDA-MB-231 cells were positive for CCR5 on a gel. qPCR analysis failed to determine Ct values for GAPDH and p53. That is why we were unable to calculate gene expression values for target genes and the experiment should be repeated.Item Restricted DIETARY PATTERNS OF ELDERLY INDIVIDUALS WITH AND WITHOUT ALZHEIMER'S DISEASE IN KAZAKHSTAN: A COMPARATIVE STUDY OF NUTRIENT INTAKE, FOOD GROUPS, AND OVERALL DIETARY QUALITY(Nazarbayev University School of Medicine, 2024) Maken, AruzhanAlzheimer's disease (AD) is the leading cause of mortality and disability in the elderly population worldwide. While various factors contribute to AD development and progression, the role of dietary patterns, particularly in under-studied regions, remains unclear. This study analyzed the dietary intake of individuals over 50, with and without AD, in Kazakhstan to determine nutritional differences and associations with AD. A cross-sectional study was conducted among AD and age-matched controls in Astana and Almaty. Dietary intake was assessed using a food frequency questionnaire. Nutrient intake was analyzed for macronutrients and micronutrients. No significant differences were observed between the nutrient intake of AD participants between cities, suggesting uniform dietary patterns among the population with AD within Kazakhstan. Furthermore, macronutrient intake revealed no differences between AD and control. Variations were observed between AD and control in micronutrients. AD participants had lower nutrient intake values in both cities, consistent with previous reports of decreased appetite and swallowing difficulties in AD patients. Our findings suggest that micronutrient intake may have neuroprotective effects in the Kazakhstani elderly population and warrants further investigation. The observed differences in micronutrient intake between AD and control groups could inform targeted nutritional interventions to prevent or mitigate AD progression in this region.Item Embargo ELECTROPORATION AS A TRANSFECTION METHOD FOR MB49 UROTHELIAL CARCINOMA CELL LINE(Nazarbayev University School of Medicine, 2023-04-25) Orazaliyeva, MadinaIn recent years, periostin has gained research interest as a possible prognostic biomarker tool for many cancer types due to its strong correlation with poor prognosis and metastasis. However, in the case of bladder cancer, the physiological role of periostin in its development and progression remains poorly understood. To explore this further, transfection, a research strategy commonly used to examine certain gene functions, was performed. In this study, the MB49 cells, a murine urothelial carcinoma cell line, were transiently transfected with periostin DNA in vitro via electroporation. The study aimed to determine whether electroporation is more effective for transfecting MB49 cells with periostin plasmid than chemical reagents. The results showed that electroporation efficiency was low relative to transfection efficiency obtained using chemical reagents, with a transfection efficiency rate of only 4.22%. This finding suggests that electroporation is not an effective method for transient transfection of MB49 cells with periostin plasmid in vitro compared to transfection using cationic lipid reagents, highlighting the limitations of this transfection method. In future studies, alternative physical and non-physical transfection techniques should be explored to improve the transfection efficiency of MB49 cells.Item Embargo EVALUATION OF NURSES’ KNOWLEDGE AND ATTITUDE ON POSTOPERATIVE PAIN MANAGEMENT IN ASTANA HOSPITALS: IMPLICATIONS FOR CONTINUING EDUCATION(Nazarbayev University School of Medicine, 2025-04-24) Potapova, Anna-MariyaDespite advancements in health care, pain persisting from surgery remains a worldwide problem for many patients left to cope with unrelieved pain. It is well known that pain management plays one of the most appropriate roles in patient rehabilitation, therefore, effective pain control has the potential to improve postoperative outcomes by decreasing pain, improving comfort and reducing complications, promoting recovery and enhancing satisfaction with care (Umuhoza et al., 2019). Although the importance of effective postsurgical pain management is currently recognized, there are still barriers for achieving it. Attitudes of health care providers toward pain, their knowledge and awareness often come in the way of receiving proper levels of interventions for pain relief. The importance of the nurses’ role in pain management during the postoperative period is emphasized, since they are often the first caregivers to assess pain, administer interventions for pain relief and observe responses from patients. The knowledge and attitudes of nurses towards pain management are vital to effective postoperative care in Kazakhstan but little is known about both. This study aims to assess the gaps in training by evaluating the current levels of knowledge and attitudes of nurses in Kazakhstan while also identifying opportunities for continuing education. Making efforts to fill these gaps can improve pain management and promote more rapid recovery with increased satisfaction level by the patient and family, highlighting the pivotal role of the nurse in optimizing postoperative care.Item Embargo EXPLORING THE MENTAL HEALTH PROMOTION OF NURSES TO PREOPERATIVE CARDIOVASCULAR DISEASE PATIENTS IN ASTANA: AN EXPLORATORY QUALITATIVE STUDY(Nazarbayev University School of Medicine, 2025-04-24) Shaldarbek, AlpamysIntroduction: This study explores how nurses in Astana, Kazakhstan, promote the mental health of preoperative cardiovascular disease (CVD) patients. Despite advancements in medical care, the psychological needs of CVD patients remain under-addressed, and the role of nurses in mental health promotion is still underexplored. Aim: The research aims to explore how nurses in Astana (Nur-Sultan) promote the mental health of preoperative cardiovascular disease (CVD) patients Methods: This research used an exploratory qualitative method. Data was collected through semi-structured interviews with ten nurses at the UMC Heart Center in Astana, Kazakhstan, specifically from cardiac surgery units. The interviews were conducted from March to April 2025, and the thematic analysis was used to analyze the data. Results: Initially, the data had 96 codes. Then, it was grouped to develop 19 subthemes and further categorized into four major themes. The main themes are “Patient Emotional Support Needs,” “Challenges to Mental Health Promotion,” and “Influencing Factors in Mental Health Promotion.” Conclusion: Nurses play a vital role in supporting the mental health of CVD patients, where communication and presence are the primary bases.Item Restricted GENERAL ATTITUDES TOWARDS AND READINESS FOR MEDICAL ARTIFICIAL INTELLIGENCE AMONG STUDENTS AT NAZARBAYEV UNIVERSITY SCHOOL OF MEDICINE.(Nazarbayev University School of Medicine, 2023-04-25) Sembekova, AnaraIntroduction: Artificial intelligence is taking over the leading positions in medical technologies. AI in healthcare not only performs basic computational tasks, but also exceeds human performance in many areas of healthcare. Aim: This study aims to analyze the attitudes and readiness of students at Nazarbayev University School of Medicine (NUSOM) to the upcoming AI integration. Methods: 91 students were asked to fill out an online survey that collected data of respondents’ characteristics and AI familiarity, general attitudes, and general readiness assessment scales. The General Attitudes towards Artificial Intelligence Scale (GAAIS) developed by Schepman and Rodway (2020) and the Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS; Karaca et al., 2021) were used in the study. Results: Most of the students had a low knowledge of AI with a mean = 45.56. Majority of the participants did not have any educational experience both in (95.6%) and outside (85.7%) the institution. Positive attitudes section: mean = 2.75 (SD = 0.64), while negative attitudes: mean = 3.01 (SD = 0.81). The readiness mean = 2.42 (SD = 0.60) out of 5.00. Conclusion: The research determined that most of the students had negative to neutral attitudes and poor readiness to medical AI. However, knowledge about AI and positive attitudes had a significant correlation with preparedness. The findings can be used to inform educational policymakers and educational institutions to develop curriculums involving AI, and ensure its ethical and optimized application in medicine. Keywords: artificial intelligence, machine learning, healthcare, medicine, attitudes, readiness, medical studentsItem Restricted HOW DO CTHRC1 AND MATRIX METALLOPROTEINASES AFFECT PATHOLOGIC ACTIVITIES OF FIBROBLAST-LIKE SYNOVIOCYTES IN RHEUMATOID ARTHRITIS?(Nazarbayev University School of Medicine, 2023) Kozhdan, KamilyaRheumatoid arthritis (RA) is an intricate autoimmune condition impacting approximately 1% of the global adult population. One of the key characteristics of this disease is the tendency of activated fibroblast-like synoviocytes (FLS) to invade and damage joint tissues. Recently, there has been a significant focus on discovering biomarkers that can precisely forecast the development of RA. One potential set of biomarkers includes collagen triple helix repeat-containing protein 1 (CTHRC1) and metalloproteinases (MMPs) proteins associated with migration and invasiveness of fibroblast-like synoviocytes, which are responsible for instigating inflammation and joint destruction in RA. The objective of this work is to investigate how CTHRC1 and MMPs are associated with the movement and invasive properties of FLS in the progression of RA. The study aims to assess whether the expression of these proteins can be used to anticipate the development of RA. The research will entail evaluating how CTHRC1 and MMP levels affect FLS pathogenesis. The conventional diagnostic markers for RA were used to show the correlation between potential biomarkers expression and disease activity. The results of this study could be significant for developing new targets for treatment and therapies for RA.Item Embargo INFLUENCE OF MATERNAL SOCIODEMOGRAPHIC FACTORS AND COMORBIDITIES ON NEONATAL CONGENITAL HEART DISEASE(Nazarbayev University School of Medicine, 2025-04-24) Nurmukhambetova, NuraiymIntroduction: The number of neonates with congenital heart disease is increasing. The incidence and development can be affected by certain maternal sociodemographic factors like age, residence, BMI, and comorbidities. Aims: This study aims to identify the incidence of congenital heart diseases among neonates in the National Research Center for Maternal and Child Health (NRCMCH), assess the maternal sociodemographic factors and comorbidities of the neonates with congenital heart disease, and evaluate the association of the development of congenital heart malformations with maternal sociodemographic factors and comorbidities. Methods: A population-based retrospective cohort study was conducted in NRCMCH in Astana from January 2024 to December 2024. All of the medical records of the neonates with congenital heart disease from this period will be collected. Frequency analysis, Chi-square test and binary logistic regression will be utilized to estimate the incidence of congenital heart defects and then evaluate the association with maternal sociodemographic factors and comorbidities. Results: Among the cohort of 616 neonates, 28.9 % were diagnosed with a congenital heart disease. There was a weak negative correlation between maternal age and congenital heart disease, (rpb = -.098, n = 613, p = .016). Neonates from rural areas are more likely to develop congenital heart malformations. There is a weak association between maternal BMI and congenital heart disease, Χ2 (2, N=410) = 12.061, p = 0.002, V = 0.172. There is no association between the presence of maternal hypertension or diabetes and the development of congenital heart disease in neonates. Conclusion: This research found that there are some associations between maternal sociodemographic factors and the development of congenital heart diseases in neonates. Particularly, maternal residence and BMI were correlated with a higher chance of getting congenital heart malformations. There was also the association with lower maternal age, which is consistent with other recent studies.Item Embargo INFLUENCE OF PERSON-CENTERED CARE ON PATIENT'S QUALITY OF LIFE: A CORRELATIONAL STUDY AT UNIVERSITY MEDICAL CENTER(Nazarbayev University School of Medicine, 2025-04-24) Amirshair, AbdildaIntroduction: Patient experiences and outcomes in healthcare settings are impacted by both medical interventions and the nature of the provided care. Person-centered care (PCC) which focuses on a holistic approach prioritizing patient’s individual preferences, needs, and values has emerged as a healthcare model aimed at improving patient’s quality of life. Despite the growing recognition of PCC globally, limited research has examined its practice and competence within Kazakhstan’s healthcare system, and no studies have yet investigated the relationship between PCC and quality of life. Aim: This study aimed to examine the influence of PCC and PCC climate on patient’s quality of life at University Medical Center (UMC) in Astana, Kazakhstan. Methods: A cross-sectional, correlational design was employed to explore the relationship between PCC and patient’s quality of life. Data was collected from 255 participants using convenience sampling. Participants were patients from two UMC clinics: Heart Center, Mother and Child Center. Questionnaires implemented in data collection included the Patient-Centered Inpatient Scale (P-CIS), Person-Centered Climate Questionnaire-Patient Version (PCQ-P), and the WHOQOL-BREF. To examine relationship between and influence of the demographic variables, PCC and PCC climate on quality of life, multiple regression analysis was performed. Results: The study found that PCC and PCC climate had a strong positive influence on patient’s quality of life in all of its domains. In turn, patient’s PCC experience was found to be significantly influenced by sociodemographic variables such as age, marital status, financial status, and area of residence whereas Kazakh language proficiency and religion significantly impacted patient’s perception of PCC climate. Conclusion: The results of the study reflected that with the proper implementation of PCC hospitals can improve healthcare outcomes of the patients by enhancing their overall quality of life. However, there is a room for the PCC practice improvement based on the poor perceptions of particular sociodemographic groups.Item Open Access INTER- AND INTRA-OBSERVER VARIABILITY OF LEFT VENTRICULAR HEMODYNAMIC FORCES DERIVED FROM FEATURE-TRACKING CARDIAC MAGNETIC RESONANCE.(Nazarbayev University School of Medicine, 2023-04-25) Ismailov, TemirlanHemodynamic forces (HDF) analysis represents a novel approach to quantify intraventricular pressure gradients (IVPG). Recently, a new noninvasive method for evaluating HDF based on feature tracking has been proposed, however data on the reproducibility of this method is still scanty. Thus, the aim of this study is to assess the reproducibility of HDF parameters derived from cardiac magnetic resonance (CMR). Twenty athletes' CMR studies were analyzed by two independent observers and 15 of them were re-analyzed by the same observer one week apart. Intraclass Correlation Coefficient and Bland-Altman plots were used to assess association and agreement of the Longitudinal HDF (A-B), Transverse HDF (L-S), and Impulse Angle. For two different observer measurements, there was a good association for the A-B and L-S (ICC 0.82 and 0.85, respectively; p<0.001), and quite a good association for the Impulse Angle (ICC 0.67; p<0.012). For the same observer's measurements one week apart, the ICC values for A-B, L-S, and Impulse Angle showed excellent correlation and high statistical significance (0.89, 0.93, and 0.82, respectively; p<0.001). The results of this study showed a low inter- and intra-observer variability of HDF parameters derived from CMR.Item Open Access INVESTIGATING ZEB-1 MEDIATED DRUG RESISTANCE IN SOLID TUMORS(Nazarbayev University School of Medicine, 2024-04-22) Faizrakhman, KamilaThe epithelial-to-mesenchymal transition (EMT) is a cellular program, through which epithelial cells lose their normal, epithelial phenotype, and become mesenchymal. This process is found to play a critical role in enhanced therapy resistance and metastatic capacities in many solid tumors. One of the most important players that activate EMT is Zeb1, which belongs to the family of ZEB transcription factors, and it alone was shown to affect the poor clinical outcomes of cancer patients due to elevating the radio-resistance and multidrug resistance in a variety of tumors. Here, we examined the effect of a combination of active compounds that are FDA approved drugs and inhibitors targeting protein kinase C (PKC) on the Zeb1 expressing breast cancer cells at distinct stages of the EMT, and concluded that the resistance of Zeb1 can be affected by kinase inhibitors, by counteracting its effect on cell cycle arrest at G1 proliferation phase. These results open new opportunities for manipulating the Zeb1-mediated therapy-resistance pathway in breast cancer, and consequently other solid tumors.Item Embargo KNOWLEDGE AND ATTITUDES REGARDING HIV/AIDS AMONG UNDERGRADUATE STUDENTS AT NAZARBAYEV UNIVERSITY: A CROSS-SECTIONAL STUDY(Nazarbayev University School of Medicine, 2025-05-06) Ismagulova, AlinaIntroduction: Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) continues to be a considerable problem around the world and in Kazakhstan. The rates of infection tend to be rising particularly among young adults thus the need to launch an awareness and prevention drive. Understanding university student’s knowledge and attitude towards HIV/AIDS is a necessary step to create impactful and well-received strategies and stigma reducing interventions. Aims: This study aims to assess the current knowledge and attitudes regarding HIV/AIDS among students at Nazarbayev University and to explore demographic factors associated with the students' knowledge and attitudes toward HIV/AIDS. Methods: A quantitative cross-sectional survey was conducted among 456 undergraduate students from Nazarbayev University. Data were collected via an anonymous online survey after participants were contacted with a request to participate. Demographic characteristics were analyzed using descriptive statistics and the association between demographic traits and HIV/AIDS knowledge and attitude was determined through multiple regression analysis. Results: The study reported a total of 66.7% of students had insufficient knowledge of HIV/AIDS and mean knowledge score was 4.83 (out of 8), which represents moderate level of awareness. Although 70.8% of the students displayed positive attitudes, significant percentages of negative perceptions were seen (29.2%), especially in casual contact with HIV/AIDS patients. Being female, having a high level of knowledge, and sexual experience were associated with a more positive attitude. Conclusions: These results underline an urgent need to implement specific educational strategies that will improve knowledge and influence attitudes about HIV/AIDS among students. University curricula should encompass education on HIV/AIDS, and stigma reduction programs should be implemented for better knowledge and attitudes.Item Embargo LIVED EXPERIENCES OF VICTIMS AFFECTED BY THE 2024 FLOOD DISASTER IN AKTOBE REGION, KAZAKHSTAN: A PHENOMENOLOGICAL STUDY(Nazarbayev University School of Medicine, 2025-04-24) Baiseitov, DiasIntroduction: During the Spring of 2024, Kazakhstan faced one of the most devastating disasters in the last century. Flooding affected over two-thirds of the country’s territory, displacing people and causing significant community disruptions. Beyond physical and economic losses, the disaster led to significant mental health issues, such as stress and grief, faced by the affected people. Aim: The study aims to explore the lived experiences of victims affected by flood disasters. Methods: This study is phenomenological qualitative research using Van Manen’s data analysis approach. The study sample is 13 people who faced flooding in the Aktobe Region and were the most damaged and unprepared for the disaster. The data collection was in the form of In-Depth interviews, where people were recruited through referral sampling, ensuring every single story was highly suitable for the study. The analysis determined shared topics about which people were most concerned. Meanwhile, the study gives a place for every narrative, highlighting the importance of individuals’ perspectives. The study is aligned to maintain strict confidentiality, accuracy, rigor, and trustworthiness. Results: Initially, 183 codes were identified. Then, the codes were summarized according to meaning, leading to 26 subthemes and further categorized into six themes. The major themes are: Disruption of Home, Livelihood, and Daily Life; Emotional Impact; Coping Mechanisms; Impact on Family; Impact on Community, and Disaster Response and Adaptation. Conclusion: This study showed an urgent need for straightening disaster response mechanisms from all perspectives: starting from personal resilience, and ending with more effective policies. The disaster substantially influenced people’s intrapersonal relations and their mental and material status.